Sampo Antonella Valeria, Palena Celina, Ganzer Luciano, Maccari Virginia, Estofán Gustavo, Hernández Mariana
CIGOR - Centro Integral de Ginecología, Obstetricia y Reproducción. Córdoba, Argentina.
JBRA Assist Reprod. 2017 Sep 1;21(3):212-216. doi: 10.5935/1518-0557.20170041.
To assess Body Mass Index (BMI) effects on the results obtained from ICSI cycles.
We studied 266 ICSI cycles performed between January 2014 and December 2016. The patients were grouped according to their BMI in: Normal (18.5-24.9), Overweight (25.0-29.9) and Obese (>30). We compared the following variables between the groups: number of antral follicles, ovarian stimulation length, gonadotropin dose used, maximum estradiol level, follicles developed/antral follicles, retrieved oocytes/developed follicles and mature/retrieved oocytes, normal fertilization rate, embryo achieved/normal fertilized oocytes, clinical pregnancy and implantation rates. We used the Kruskal-Wallis and the Chi square tests. p<0.05 was considered significant.
Normal, Overweight and Obese patients presented comparable values for number of antral follicles (11.6±5.4, 12.5±5.5, 12.2±5.7), ovarian stimulation length (7.5±1.4, 7.6±1.1, 7.8±1.3) and gonadotropin dose used (2043±489, 1940±536, 2109±605). Obese patients had lower values of estradiol (1560±610, 1511±635, 1190±466; p=0.018), developed follicles (81%, 76%, 70%; p<0.0001), and retrieved oocytes (91%, 90%, 84%; p=0.0017); and not significantly lower values of mature oocytes (82%, 82%, 77%; p=0.26). The groups had comparable fertilization rates (72%, 73%, 69%) and embryo achieved rates (67%, 63%, 72%). The normal group had higher, but not significantly higher pregnancy and implantation rates (43%, 40%, 38%, p=0.53; and 33%, 26%, 23%; p=0.11), and significantly higher ongoing pregnancy rates (37%, 33%, 33%, p=0.042).
Increased BMI patients had impaired ovarian response and lower pregnancy rates in ICSI cycles.
评估体重指数（BMI）对卵胞浆内单精子注射（ICSI）周期结果的影响。
我们研究了2014年1月至2016年12月期间进行的266个ICSI周期。患者根据BMI分为：正常（18.5 - 24.9）、超重（25.0 - 29.9）和肥胖（>30）。我们比较了各组之间的以下变量：窦卵泡数量、卵巢刺激时间、促性腺激素使用剂量、最高雌二醇水平、发育卵泡/窦卵泡、获卵数/发育卵泡以及成熟/获卵数、正常受精率、获得的胚胎数/正常受精的卵母细胞数、临床妊娠率和着床率。我们使用了Kruskal - Wallis检验和卡方检验。p<0.05被认为具有统计学意义。
正常、超重和肥胖患者的窦卵泡数量（11.6±5.4、12.5±5.5、12.2±5.7）、卵巢刺激时间（7.5±1.4、7.6±1.1、7.8±1.3）和促性腺激素使用剂量（2043±489、1940±536、2109±605）具有可比性。肥胖患者的雌二醇水平较低（1560±610、1511±635、1190±466；p = 0.018）、发育卵泡比例较低（81%、76%、70%；p<0.0001）以及获卵数较低（91%、90%、84%；p = 0.0017）；成熟卵母细胞比例无显著降低（82%、82%、77%；p = 0.26）。各组的受精率（72%、73%、69%）和获得胚胎的比例（67%、63%、72%）具有可比性。正常组的妊娠率和着床率较高，但无显著差异（43%、40%、38%，p = 0.53；以及33%、26%、23%；p = 0.11），而持续妊娠率显著较高（37%、33%、33%，p = 0.042）。
BMI增加的患者在ICSI周期中卵巢反应受损且妊娠率较低。
